How a CPAP machine can address sleep woes

A CPAP machine is often recommended for people who have breathing-related sleep disturbance, such as obstructive sleep apnea. The machine pushes a steady stream of air into the nose through a mask the user wears all night. CPAP machines improve sleep and have been shown to help people lose weight and reduce high blood pressure, diabetes and heart disease.

Those are real and significant benefits. The National Commission on Sleep Disorders Research has estimated that obstructive sleep apnea may cause 38,000 cardiovascular deaths each year.

What happens during obstructive sleep apnea is that the person actually stops breathing. Dr. Paul G. Matthew of Harvard Medical School called its effects on the brain “repeated moments of suffocating.”

CPAP use also improves life during the day — which was what Rich Harris, 58, of Great Mills, Md., was seeking. The retired U.S. Navy member knew his snore-filled nights weren’t just worrying his sleep-deprived wife, they resulted in his daytime sleepiness that made it hard to drive safely or focus on his work.

The link between relationship quality and CPAP use

“It’s common that a patient will come into [our] clinic because their spouse or partner is worried about hearing them stop breathing or is bothered by the snoring,” says clinical psychologist Kelly Baron, at Rush University Medical Center in Chicago.

“We found that men who were in marriages with lower conflict had higher use of their CPAPs,” she said. “In addition, couples’ relationship conflict decreased over the three months we tracked them. This tells us not only do supportive relationships matter, but people feel better about their relationships when they are getting better sleep.”

Yet despite the CPAP’s proven benefits, one in three users’ CPAP machines will be gathering dust in a corner, unused, within a decade, according to the American Association of Sleep Technologists.

Nine ways to succeed as a CPAP couple

“The couples that collaborate together have the best outcomes with CPAP use,” according to sleep disorders researcher Faith Luyster, assistant professor of health and community systems at the University of Pittsburgh School of Nursing in Pennsylvania.

Try these nine steps to support your spouse:

Be flexible at bedtime. “I recommend the patient figure out a routine. For example, many couples set aside a few minutes to talk or snuggle, then say goodnight, and put on the mask,” says Baron. If the machine’s noise is bothersome, try using a fan or white noise machine to obscure it.

Time conversations about CPAP problems strategically. Neither one of you will be up for trouble-shooting at 3 a.m. “Bring it up in a neutral environment where you’re not upset, but when you’re both in a good mood,” recommends Patrick Shima, who has used a CPAP for 18 years, beginning shortly before his retirement from the U.S. Navy. The 61-year-old Lincoln, Calif., resident recalls: “I had a lot of snoring, which was bad for my wife.” He also was extremely tired through the day and frequently had headaches.

Work together with the CPAP machine. “When patients reported the spouse helped set up, fill the water, adjust and clean the machine, they used it more,” says Baron. Be proactive and ask for training alongside your spouse, advises Luyster.

Be patient. An adjustment period of weeks to months might include trying different types of masks, tweaking machine settings and getting used to the feel and look of the CPAP, says Baron. Harris, who wears a mask that covers his nose, admits that his CPAP use is still a work in progress. When his allergies cause extreme congestion, he’ll often try to sleep without the CPAP — returning quickly to the days of daytime tiredness and an exhausted wife. Shima reports that his wife’s patience with the machine at the beginning helped. “She didn’t complain about wearing it and she got used to the noise. After a while, that subtle noise was more appealing than not in terms of having a background white noise to help her sleep,” he says.

Highlight the machine’s benefits. Shima points out that some of the current CPAP models communicate with apps on your smartphone or tablet. He enjoys reviewing the sleep data his machine collects each night. A savvy spouse could point out these high-tech features.

Encourage, don’t nag. Baron occasionally has patients tell her that they feel pushed into CPAP treatment by their spouse. “In those cases, the recommendation would be to provide encouragement, but in the end, the patient needs to be the one who makes the decision,” she says.

Try on your partner’s mask. Shima, who wears a full face CPAP mask covering his nose and mouth, says it might help build sympathy if you experience your partner’s mask, with the machine on.

Get help. A minority of people experience anxiety or claustrophobia when they start using the CPAP. Barron recommends working with a behavioral sleep medicine specialist to overcome those barriers.

Say “thank you.” Luyster’s research review, published in the March 2017 issue of the Journal of Clinical Sleep Medicine, documents that when one partner uses a CPAP, his or her partner often reports better sleep as well as better daytime functioning and improved mood. Luyster recommends letting your spouse know the ways in which the CPAP helps you, too.